Evidence map›Paper›PMID 41859245›Full record

ArticleDrug and alcohol dependence reports2026

Higher drug overdose mortality among non-hispanic black adults aged 55 and older in the U.S.: Analysis of national death records from CDC's WONDER database (1999-2023).

Zongbo Li, Yanwei Jin, M Kumi Smith, Bruce R Schackman, Erika L Crable, Czarina N Behrends, Karla Wagner, Alexander Y Walley, Brandon D L Marshall, Xiao Zang

Abstract read
In one paragraph

Article in Drug and alcohol dependence reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Zongbo LiDivision of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, MN, USA.
Yanwei JinDivision of Biostatistics & Health Data Science, School of Public Health, University of Minnesota, Minneapolis, MN, USA.
M Kumi SmithDivision of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA.
Bruce R SchackmanDepartment of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA.
Erika L CrableDepartment of Psychiatry, School of Medicine, University of California San Diego, La Jolla, CA, USA.
Czarina N BehrendsDepartment of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA.
Karla WagnerSchool of Public Health, University of Nevada, Reno, NV, USA.
Alexander Y WalleyMassachusetts Department of Public Health, Bureau of Substance Addiction Services and Grayken Center for Addiction, Section of General Internal Medicine, Boston Medical Center and Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA.
Brandon D L MarshallDepartment of Epidemiology, Brown University School of Public Health, Providence, RI, USA.
Xiao ZangDivision of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, MN, USA.

Funding

Reversing Overdose Epidemics through Simulation, Collaboration, and Unified Efforts (RESCUE)R33DA062346 · NIDA · UNIVERSITY OF MINNESOTA · PI Brandon David Lewis Marshall, Xiao Zang · 2024 to 2026
$3.2M
NIDA NIH HHS R33 DA062346
6 · The paper itself

Abstract

Background: Non-Hispanic Black adults ages 55 and older experienced the sharpest increases in drug overdose mortality from the mid-2010s onwards. We aimed to elucidate longitudinal patterns of rising overdose mortality among this population and identify key substances driving this trend. Methods: We analyzed national death records from CDC's WONDER database (1999-2023) to examine unintentional drug overdose death rates across racial/ethnic and age groups, focusing on non-Hispanic Black adults ages 55 and older. We examined trends by substance type and census region (i.e., Northeast, Midwest, South and West), and introduced a metric named contribution ratio (CR)-defined as the ratio of the change in overdose mortality involving a specific substance to the overall change in drug overdose mortality-to quantify the contributions of different substances to the increase in overdose mortality. Results: Since 2015, drug overdose mortality among non-Hispanic Black adults ages 55 and older increased more than among younger Black adults, older adults of other racial/ethnic groups, and younger adults of all racial/ethnic groups, many of whom experienced more modest increases during this period. By 2019, this group had the highest overdose death rate nationwide. CR analyses showed that cocaine and its co-involvement with fentanyl contributed most to the mortality increases among this population. Regional patterns varied, with methamphetamine-related deaths emerging in the U.S. West. Overdose mortality involving cocaine without opioid co-involvement rose steadily among older non-Hispanic Black adults across all regions, potentially reflecting heightened age-related vulnerability. Conclusions: The rapid rise in overdose mortality among non-Hispanic Black adults ages 55 and older-largely associated with cocaine with and without fentanyl-signals an urgent public health crisis requiring targeted interventions.

Indexed as

AgeCocaineDrug overdose deathsFentanylPolysubstance useRace/ethnicity

Identifiers

PMID41859245
PMCPMC12995812

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.